Neonatal Nursing: Scope and Standards of Practice, 3rd Edition

By , and National Association of Neonatal Nurses

The Neonatal Nursing: Scope and Standards of Practice, 3rd Edition, is an essential document for every neonatal nurse practicing in the United States. The scope of practice statement answers the who, what, when, where, how, and why questions of neonatal nursing. The standards provide authoritative statements of the actions and behaviors that all registered neonatal nurses are expected to competently perform, regardless of role, population, specialty, and setting.
The product of extensive thought work by many registered nurses, this new edition provides 17 national standards of practice and professional performance. Each standard is accompanied by detailed competencies for the three practice levels. This premier professional resource informs and guides neonatal nurses in their vital work providing safe, quality, and competent care. It is a must-have for every registered neonatal nurse.

• Language: English
• Publisher: Nursesbooks
• Release date: Sep 17, 2021
• ISBN: 9781947800953

Book preview

The American Nurses Association (ANA) and National Association of Neonatal Nurses (NANN) are national professional associations. This joint publication reflects the position of ANA and NANN regarding the scope and standards of neonatal nursing practice and should be reviewed in conjunction with state board of nursing regulations. State law, rules, and regulations govern the practice of nursing, while Neonatal Nursing: Scope and Standards of Practice, 3rd Edition guides registered nurses in the application of their professional skills and responsibilities.

About the American Nurses Association

The American Nurses Association (ANA) is the only full-service professional organization representing the interests of the nation’s 4.2 million registered nurses through its constituent/state nurses associations and its organizational affiliates. The ANA advances the nursing profession by fostering high standards of nursing practice, promoting the rights of nurses in the workplace, projecting a positive and realistic view of nursing, and by lobbying Congress and regulatory agencies on health care issues affecting nurses and the public.

American Nurses Association

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Silver Spring, MD 20910

About National Association of Neonatal Nurses

The National Association of Neonatal Nurses (NANN) supports the professional needs of neonatal nurses throughout their careers and shapes the field of neonatal nursing through excellence in practice, education, research, and professional development. The longest established professional organization for neonatal nurses, NANN, provides its members a connection to the strongest and most vibrant community of neonatal nurses in the United States.

Cataloging-in-Publication data on file with Library of Congress

Copyright © 2021 American Nurses Association and National Association of Neonatal Nurses. All rights reserved. No part of this book may be reproduced or used in any form or any means, electronic or mechanical, including photocopying and recording, or by any information storage and retrieval system, without permission in writing from the publisher.

ISBNs

Print 978-1-947800-93-9

ePDF 978-1-947800-94-6

ePUB 978-1-947800-95-3

Mobi 978-1-947800-96-0

SAN: 851-3481

Table of Contents

Acknowledgments

Scope of Neonatal Nursing Practice

Definition and Overview of Professional Neonatal Nursing

History of Neonatal Nursing

Underlying Assumptions of Neonatal Nursing

Practice Characteristics of Neonatal Nursing

Continuous Assessment

Developmental Care

Health Promotion

Environment

Family-Centered Care

Culturally Sensitive Care

Spiritual Care

The Code of Ethics for Nurses

Discharge Planning

Advocacy

Quality Assurance and Evidence-Based Practice

Patient Safety

Research

Practice Environments and Levels of Care in Neonatal Nursing

Education, Certification, and Roles in Neonatal Nursing

Future Considerations

Standards of Practice for Neonatal Nursing

Standard 1. Assessment

Standard 2. Diagnosis

Standard 3. Outcome Identification

Standard 4. Planning

Standard 5. Implementation

Standard 5A. Coordination of Care

Standard 5B. Health Teaching and Health Promotion

Standard 6. Evaluation

Standards of Professional Performance for Neonatal Nursing

Standard 7. Ethics

Standard 8. Culturally Congruent Practice

Standard 9. Communication

Standard 10. Collaboration

Standard 11. Leadership

Standard 12. Education

Standard 13. Evidence-Based Practice and Research

Standard 14. Quality of Practice

Standard 15. Professional Practice Evaluation

Standard 16. Resource Utilization

Standard 17. Environmental Health

Glossary

References

Index

Acknowledgments

This document was developed by the National Association of Neonatal Nurses (NANN) Scope and Standards Task Force. The task force members gratefully acknowledge the work of the previous task forces that initiated the original documents on neonatal nursing practice. The early versions of the manuscript for this edition were modified based on thoughtful comments and editing suggestions made by volunteer reviewers and by the NANN Board of Directors.

This edition is dedicated to the past, present, and future families and staff of the NICU, working in partnership to benefit all babies in our care.

NANN Scope and Standards Task Force

Kathryn J. Malin, PhD, APRN, NNP-BC, Chair

Catherine Witt, PhD, APRN, NNP-BC, Chair

Karen M. Kopischke, MS, RNC, NNP-BC

Linda Merritt, PhD, RNC-NIC, CNE

Deidre B. Miller, MSN-Ed, RNC-NIC

Lisa Smotrich, BSN, NPD-BC, CCRN-K

NANN Staff Liaisons

Dionne Wilson, Executive Director

Andie Bernard, Managing Editor

Evan Richards, Assistant Editor

NANN Board of Directors, 2019–2020

Joan Rikli, MBA, MSN, RN, CPNP, NE-BC, President

Gail Bagwell, DNP, APRN, CNS, President-Elect

Susan Meier, DNP, APRN, NNP-BC, Secretary–Treasurer

Linda Merritt, PhD, RNC-NIC, CNE, Director at Large

Lisa Smotrich, BSN, RN-BC, CCRN, Director at Large

Media Esser, PhD, NNP-BC, APNP, CWN, Director at Large

Rachael Edjou, NNP-BC, APNP, CPNP-PC, Director at Large

Reena Blackwell, MSN, RNC-NIC, NE-BC, Staff Nurse Director at Large

Tommie Farrell, BSN, RNC-NIC, Staff Nurse Director at Large

Elizabeth Welch-Carre, EdD, MS, APRN, NNP-BC, National Association of Neonatal Nurse Practitioners (NANNP) Council Chair

NANN Board of Directors, 2020–2021

Gail Bagwell, DNP, APRN, CNS, President

Joan Rikli, MBA, MSN, RN, CPNP, NE-BC, Immediate Past President

Luann Jones, DNP, APRN, NNP-BC, NE-BC, Secretary-Treasurer

Julie Williams, DNP, CRNP, NNP-BC, Director at Large

Linda Merritt, PhD, RNC-NIC, CNE, Director at Large

Media Esser, PhD, NNP-BC, APNP, CWN, Director at Large

Rachael Edjou, NNP-BC, APNP, CPNP-PC, Director at Large

Erica Van Inwagen, BSN, RN, CCRN, Staff Nurse Director at Large

Reena Blackwell, MSN, RNC-NIC, NE-BC, Staff Nurse Director at Large

Bobby Bellflower, DNSc, NNP-BC, National Association of Neonatal Nurse Practitioners (NANNP) Council Chair

American Nurses Association (ANA)Staff

Carol J. Bickford, PhD, RN-BC, CPHIMS, FAMIA, FHIMSS, FAAN, Content Editor

Katie Boston-Leary, PhD, MBA, MHA, RN, NEA-BC, Contributor

Erin Walpole, BA, PMP, Production Editor

James Angelo, MA, Publications Manager

Scope of Neonatal Nursing Practice

Definition and Overview of Professional Neonatal Nursing

Neonatal nursing is the specialized practice of caring for the neonate, infant, and family from birth and initial hospitalization through discharge and early follow-up care. This highly specialized nursing practice includes caring for infants who are born prematurely and those born at term or beyond who are experiencing illness or complications such as birth defects, infection, cardiac malformations, and surgical problems. Although the neonatal period is defined as the first month of life, these newborns are often hospitalized for months. Therefore, neonatal nursing encompasses care of infants who may experience long-term complications related to their prematurity or complications and illness [National Association of Neonatal Nursing (NANN), n.d.]. Neonatal nursing practice may also include care of the well newborn.

Medical and technological breakthroughs have expanded the ability to save extremely small and premature infants as well as profoundly ill infants, which has increased the survival rates to 10 times better than they were 15 years ago (NANN, n.d.). With these innovations and practice changes, the nursing care needs of this population have grown. As a result, nurses who specialize in neonatal nursing may take care of infants up to 2 years of age (NANN, n.d.).

The population served by the neonatal registered nurse is diverse and increasing in numbers. According to the Centers for Disease Control and Prevention (CDC), preterm birth rates have increased for the past 3 years with 1 in 10 infants being born prematurely. Additionally, 8.3% of infants are born with low birth weight in the United States (Martin, Hamilton, Osterman, Driscoll, & Drake, 2018). The U.S. Department of Health and Human Services reported that in 2018, 4% of all births required assisted ventilation immediately after birth, and of those, 34% required